Lung-RADS 2022 Calculator
Categorize lung cancer screening CT findings with ACR Lung-RADS v2022 — solid, part-solid, and ground-glass nodules — and get the matching management recommendation.
What is Lung-RADS?
Lung-RADS is the ACR's structured reporting system for low-dose CT lung cancer screening. It sorts findings into categories 0 through 4X based on nodule type, size, and growth, each linked to a management recommendation. This calculator applies the 2022 criteria to return the category, malignancy risk, and follow-up interval.
Lung-RADS Calculator
Multi-nodule scoring & structured reporting based on ACR Lung-RADS v2022 (November 2022)
How to Use
- Add each pulmonary nodule and pick its type, status, and size. Every change re-scores that nodule live.
- The overall Lung-RADS reflects the most suspicious nodule; an S-modifier or incomplete exam is applied study-wide.
- Use the report-detail panels (study-level and per-nodule) to populate the full structured report.
Pulmonary nodules
Add each nodule and set its type, status, and size. Scoring updates live as you go.
2 Study Report Details optional Fill these in for a richer, fully tailored full report — they never change the score.
These study-level fields appear in the structured report only. They never affect the Lung-RADS score. Non-scored sections default to “Unremarkable.” unless you choose Other.
Study modifiers
Optional study-wide overrides: mark an incomplete exam (Category 0) or flag significant non-lung findings (S-modifier).
Examples: coronary calcification, emphysema, interstitial lung disease, adrenal nodule. Refer to ACR Incidental Findings guidelines.
Quick Reference: Size Thresholds with Volumes
Solid Nodule (Baseline)
- Cat 2: < 6 mm < 113 mm³
- Cat 3: 6-8 mm 113-268 mm³
- Cat 4A: 8-15 mm 268-1,767 mm³
- Cat 4B: ≥ 15 mm ≥ 1,767 mm³
Solid Nodule (New)
- Cat 2: < 4 mm < 34 mm³
- Cat 3: 4-6 mm 34-113 mm³
- Cat 4A: 6-8 mm 113-268 mm³
- Cat 4B: ≥ 8 mm ≥ 268 mm³
Part-Solid (Baseline)
- Cat 2: Total < 6 mm < 113 mm³
- Cat 3: Total ≥ 6 mm, solid < 6 mm
- Cat 4A: Solid 6-8 mm 113-268 mm³
- Cat 4B: Solid ≥ 8 mm ≥ 268 mm³
Non-Solid / GGN
- Cat 2: < 30 mm < 14,137 mm³
- Cat 3: ≥ 30 mm (baseline/new) ≥ 14,137 mm³
- Cat 2: ≥ 30 mm stable/slow growing
Juxtapleural: < 10 mm (≤ 24 mm³), solid, smooth margins, oval/lentiform/triangular = Category 2.
About this calculator
ACR Lung-RADS v2022 standardizes the reporting and management of pulmonary nodules detected on low-dose CT (LDCT) lung cancer screening. Nodules are categorized 1-4X based on type (solid, part-solid, non-solid/GGN, airway, atypical pulmonary cyst), size, and growth status, with the overall assessment driven by the most suspicious nodule. The S-modifier flags clinically significant findings unrelated to lung cancer, and Category 0 denotes an incomplete exam.
- American College of Radiology. Lung CT Screening Reporting & Data System (Lung-RADS) v2022. acr.org/Lung-RADS
- Brock University / McWilliams malignancy risk calculator: brocku.ca risk calculators
- ACR Incidental Findings management: acr.org/Incidental-Findings
For educational and reference purposes only. Always consult a qualified radiologist for clinical decisions.
Copy the 4-item impression or the full structured ACR Lung-RADS v2022 report to your clipboard.
Frequently asked questions
What is Lung-RADS used for?
Lung-RADS (Lung CT Screening Reporting and Data System) standardizes interpretation and management of low-dose CT lung cancer screening exams. It assigns each scan a category from 0 to 4X based on the most suspicious nodule, linking findings to follow-up recommendations and estimated malignancy risk.
How are Lung-RADS categories defined?
Categories range from 0 (incomplete) and 1 (negative) through 2 (benign), 3 (probably benign), 4A, 4B, and 4X (increasingly suspicious). Assignment depends on nodule composition (solid, part-solid, ground-glass), size in millimeters, and whether the nodule is new or growing.
What size threshold separates Lung-RADS 3 from 4A?
For a solid nodule at baseline, ≥6 to <8 mm is category 3, while ≥8 to <15 mm is category 4A. Part-solid nodules are categorized by their solid-component size. New or growing nodules are upgraded according to the 2022 criteria.
Does Lung-RADS replace clinical judgment?
No. Lung-RADS provides standardized categories and suggested management intervals, but the radiologist may modify recommendations based on comorbidity, patient preference, and clinical context. This calculator is an educational and reporting aid, not a substitute for professional interpretation.